Medicare made simple.
Penalties made avoidable.
Millions of seniors overpay for Medicare every year — through late enrollment penalties, wrong plan choices, and benefits they never knew existed. This guide fixes that.
📅 Key Medicare Deadlines
Medicare Part A, B, C, D — explained simply
Most people know Medicare exists. Most don’t know which parts they need — and that gap costs them thousands.
Inpatient hospital stays, skilled nursing, hospice. Most people get it free if they worked 10+ years.
Doctor visits, outpatient care, preventive services. This is where most penalty mistakes happen.
Private plans bundling A+B and usually D. Often lower premiums but with network restrictions.
Prescription drug coverage. The $2,000 out-of-pocket cap starts in 2025.
Not sure which plan is right for you?
GoHealth’s free comparison tool shows every Medicare plan in your ZIP code side by side — with licensed agents available if you need help choosing.
No obligation · Takes 2 minutes
Late enrollment penalties that follow you for life
These are permanent. Miss your enrollment window and you pay more every single month — forever. No exceptions.
⚠️ The Medicare Penalty Trap
Unlike other insurance, Medicare penalties aren’t temporary. They’re added to your premium permanently — for the rest of your life.
Part B Late Penalty
For every 12-month period you were eligible but didn’t enroll, your Part B premium goes up 10% — forever. Wait 3 years? That’s 30% more every month for life.
Part D Late Penalty
For every month without creditable drug coverage, you’re charged 1% of the national base premium ($36.78 in 2026). These add up fast and they’re permanent.
Still working at 65?
You may delay Part B if your employer coverage is creditable. Verify before assuming you need to enroll.
COBRA doesn’t count
COBRA coverage is NOT creditable for Part B delay purposes. Enroll in Medicare the moment COBRA starts.
Spouse’s employer plan
Coverage through a spouse’s CURRENT employer counts. A retired spouse’s plan usually does not.
Your 7-month window
Starts 3 months before your 65th birthday, includes your birthday month, ends 3 months after. Don’t miss it.
Medigap vs Medicare Advantage — which is right for you?
This choice affects every dollar you spend on healthcare for the rest of your life. Get it right the first time.
| Medigap (Supplement) | Medicare Advantage (Part C) | |
|---|---|---|
| Monthly premium | $150–$350/month | Often $0/month |
| Doctor choice | Any doctor that takes Medicare | Network only (HMO/PPO) |
| Out-of-pocket costs | Little to none after premium | Copays for every visit |
| Annual OOP max | Near $0 with good plan | Up to $9,450 in 2026 |
| Travel coverage | Works anywhere in the US | Only in your network area |
| Extra benefits | None | Dental, vision, hearing |
| Best for | Frequent medical needs, travelers | Healthy, budget-conscious |
⚠️ The Timing Warning: You have guaranteed acceptance into any Medigap plan during your 6-month Medigap Open Enrollment Period (starts when you’re 65 and enrolled in Part B). Miss this window and insurers can charge more or deny you based on health — permanently.
$50/month GLP-1 program for Medicare members
Starting July 1, 2026, eligible Medicare Part D members can access weight loss drugs like Wegovy and Zepbound for a flat $50/month — at any dose.
✅ Who qualifies
- Enrolled in Medicare Part D or MA with drug coverage
- BMI of 35 or higher, OR
- BMI 27+ with a qualifying condition
- Not already receiving GLP-1 coverage through Part D
- Drugs covered: Wegovy, Zepbound KwikPen, Forxiga
📋 Key details
- Runs July 1, 2026 – December 31, 2027
- Flat $50/month at any dose
- Saves up to $900 over 18 months
- The $50 does NOT count toward your $2,000 OOP cap
- Ask your doctor or call 1-800-MEDICARE to check
Still save on GLP-1 prescriptions with ReadyRx
ReadyRx compares prescription prices across pharmacies instantly. Free to use, no insurance required. Many seniors save $50–$200+ on a single prescription.
Free · No signup required
Your state may be paying your Medicare premium
Medicare Savings Programs help low-to-moderate income seniors cover Part B premiums, deductibles, and copays. Millions qualify but never apply.
QMB Program
Pays Part A and B premiums, deductibles, and copays. Income limit: ~$1,255/month individual (2026).
SLMB Program
Pays Part B premium only. Income limit: ~$1,478/month individual. Often overlooked by those just over QMB limits.
Extra Help (LIS)
Reduces Part D drug costs dramatically. Income limit ~$22,590 individual. Apply through SSA.gov — not Medicare.
💡 How to apply: Contact your State Medical Assistance (Medicaid) office or call 1-800-MEDICARE. Applications are free and take about 15 minutes. Don’t leave this money on the table.
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Affiliate Disclosure: Some links are affiliate links. We may earn a commission at no additional cost to you. This is not medical or financial advice. Verify benefit details at medicare.gov or by calling 1-800-MEDICARE.